The Vanderbilt Chapter of the IHI Open School Quarterly Report May 2010 Curriculum Projects: 1. Interdisciplinary Introduction to Quality Improvement Elective 2. VMS IV Quality Improvement Practicum QI Projects: 3. Safe Surgery Project 4. Medicine/Radiology Overnight Imaging Studies Follow-Up Project Partnerships for Project Generation: 5. VIHI-Hospital Corporation of America Partnership and Projects 6. VIHI-Shade Tree Family Clinic Partnership and Projects 7. VIHI-West End Women s Health Center Partnership and Projects 8. VIHI-Vanderbilt University Medical Center Partnership and Projects Other Initiatives: 9. Certificate in Patient Safety and Quality Improvement 10. Website 11. Faculty Advisory Board Leadership: Founders and Chapter Leaders: Irving Ye (VMS III) Piotr Pilarski (VMS III) School of Medicine School Leaders (newly-elected): Scott Hagan (VMS I) Tim Lockney (VMS I) Faculty Advisors: Bonnie Miller, MD (D) Jacob Hathaway, MD School of Nursing School Leaders: Emily Holcombe (SON II) Melinda McCusker (SON II) Faculty Advisors: Linda Norman, DSN, RN (D) Tom Cristenbery, MSN, PhD, RN Terri Crutcher, MSN, RN Richard Watters, MEd, PhD, RN Owen School of Management School Leaders: Janice Babbs (Owen I) Julie McNeil (Owen I) Faculty Advisors: Jon Lehman, MBA (D) Rangaraj Ramanujam, PGDM, PhD
1. Interdisciplinary Introduction to Quality Improvement Elective (M, N, O) - Create a semester-long elective that consists of lectures and case-based learning experiences to serve as an introduction to quality improvement - Carol Callaway-Lane, RN, MSN, ACNP-BC - Jacob Hathaway, MD - Bonnie Miller, MD - Rangaraj Ramanujam, PGDM, PhD - Richard Watters, MEd, PhD, RN - Scott Hagan (VMS I) - Matt Kynes (VMS III) - Tim Lockney (VMS I) - Jake McClure (VMS I) - Melinda McCusker (SON II) - Billy Sullivan (VMS II) - Gained initial support from Deans of three Vanderbilt graduate programs [2.8.10] - Identified faculty advisors (Callaway-Lane, Hathaway, Ramanujam, Watters) - Identified general objectives for elective - Establish course schedule (12 sessions) - Create a concrete course structure - Develop specific lesson plans [June and July] - Create a template for student presentations - Identify faculty to teach lessons - Select course title - Write elective description for course catalogue - Finalize schedule and location [ongoing] 2
2. VMS IV Quality Improvement Practicum (M) - Create an elective that would provide fourth year medical students with hands-on experience in conducting quality improvement and patient safety studies in a clinical setting - Manuel Benegas, Jr., JD - G. Waldon Garriss, III, MD, MS - Beth Ann Sastre, MD - Thomas Spain, MD - Matt Kynes (VMS III) - Assembled models for successful creation of similar electives from various IHI Open School Chapters [2.1.10] - Drafted proposal for 6 month plan of research elective with objectives and initial design [4.26.10] - Recruited initial students to participate in elective [5.1.10] - Present research elective proposal to faculty for advice [by 6.1.10] 3
3. Safe Surgery Project (M) - Improve compliance to Vanderbilt s surgical checklist in order to improve patient safety in Vanderbilt ORs - Assess the impact of whiteboard intervention and revision of the pre-incision time-out procedure on improving compliance of checklist - Marc Bennett, MD - Ron Eavey, MD - Nancye Feistritzer, MSN, RN - Dan France, MSE, MPH, PhD - Ginger Holt, MD - Scott Hagan (VMS I) - Matt Kynes (VMS III) - Tim Lockney (VMS I) - Rajshri Mainthia (VMS II) - Sabrina Poon (VMS II) - Scott Zuckerman (VMS II) - Research of current surgical checklist and time-out procedures [2.10.10] - Meetings with chief quality officer, chief hospital epidemiologist, and several surgical department heads that have helped both raise awareness of the current inadequacies of the system and helped with the implementation of a new time-out procedure [ongoing] - Survey created, presented to Holt, and med student data collection on 100 cases [3.2010] - Initial Time Out data collected (50 cases) - By summer 2010 every Vanderbilt OR will in the first phase of time-out procedure modification. We will pursue a study with 2 main components: 1) Survey - assess timeout procedure knowledge among physicians, nurses, and medical students both before and after intervention. 2) Observational study to measure compliance in Vanderbilt main hospital ORs - Analysis of collected data [ongoing] - Proposed completion date: end of August 2010 4
4. Medicine/Radiology Overnight Imaging Studies Follow-Up Project (M) BACKGROUND: - Patient with ALL suffered typhlitis and bowel perforation that was discovered after overnight delay in abdominal CT scan and read, raising issues of cross-cover documentation, prioritization of radiology scans, communication between medicine and radiology teams overnight, and others. - Improve how medicine residents follow up studies in the middle of the night - Conduct educational intervention for all of the medicine residents focusing on 1) understanding the pathway of a radiology study from ordered to read; and 2) focusing on how to best interact with radiologists overnight - Dan Stover, MD - Jessica Castilho, MD - Beth Ann Sastre, MD - Collected initial information about when imaging studies get completed and read overnight. - Conducted fishbone analysis of case. - Created survey to assess radiologists opinion of medicine residents communications to follow up overnight, cross-cover patients. - Night-hawk radiology residents filling out a preliminary survey for 2wks before the educational intervention for analysis [4/2010] - Plan educational intervention for medicine residents about how to get studies completed, read and follow-up [4/2010] - Radiology residents will fill out similar survey ~2wks after we teach medicine residents how to be better "callers [4/2010] 5
5. VIHI-Hospital Corporation of America Partnership (N, O) - Partner with Hospital Corporation of America to establish educational and career training opportunities for students HCA Administrators: - Jane Englebright, PhD, RN - Jason Hickok, MBA, RN - Barbara Olson, MS, RN - Jon Lehman, MBA - Bonnie Miller, MD - Linda Norman, DSN, RN - Rangaraj Ramanujam, PGDM, PhD - Melinda McCusker (SON II) - Conference call with HCA reps to confirm interest [12.15.10] - Received initial list of projects and mentors from HCA [1.15.10] - Meeting between Deans and HCA representatives to discuss partnership details [3.10.10] - Leaders from Owen (Janice and Julie) and the School of Nursing (Melinda) to continue discussions with HCA either individually or together - Explore the use of HCA's leaders to guest lecture for our elective - Follow up potential QI-in-action learning opportunity for our Chapter's members: HCA will be kicking off what is known as an "IHI Collaborative"; it will be led by IHI faculty who will be coming into town from Cambridge, MA and will focus on improving their patient satisfaction scores across their entire health care system 6
6. VIHI-Shade Tree Family Clinic Partnership (M, O) - Form an interdisciplinary group for improving quality and patient safety at the Shade Tree Family Clinic - Improve patient documentation by students and care providers at the Shade Tree Family Clinic - Assess and improve volunteer satisfaction to promote student volunteerism at the Shade Tree Family Clinic - Assess and improve patient satisfaction at the Shade Tree Family Clinic - Jacob Hathaway, MD - Natalie Ausborn (VMS I) - Stephanie Flavin (VMS II) - Nicole Hames (VMS II) - Meera Reddy (VMS I) - Lara Seltz (VMS I) - Volunteer satisfaction: clinic flow chart for volunteers designed and completed [1.28.10]. 6 months of Volunteer Satisfaction Survey Data and Redcap Database [2.2010] - Introduced Management students to Shade Tree Directors [2.2010] - Student Leaders Met with Dr. Hathaway and finished survey design for Patient Satisfaction [2.2010] - Student leaders met with current and outgoing Shade Tree clinic directors and Dr. Miller to inform them of the plan, and gather consent and input. - Student leaders met with patients to ensure validity and reliability of the survey tool and returned with great results. - Implement a four-week trial of survey distribution and collection via two methods. Two weeks of student clinic volunteers distributing the survey and then patients return it in a box, and two weeks student leaders handing the surveys out one on one with the patients, and then collecting in a box. Surveys will be anonymously numbered and the method with greatest yield will be used. [by 9.1.10] - Patient satisfaction survey being translated into Spanish [by 9.1.10] - Plan to implement survey for data collection late summer through fall semester. Meeting with Dr. Hathaway to determine appropriate duration. 7
7. VIHI-West End Women s Health Center Partnership (N) - Study the effectiveness of peripartum depression screening tools in preventing postpartum depression - Implement an intervention at a local women s health clinic to prevent postpartum depression and complete PDSA cycles - Tom Christenbery, MSN, PhD, RN - Terri Crutcher, MSN, RN - Tonia Moore-Davis, MSN, CNM - Sarah Wood (SON II) - Literature review of peripartum depression screening tools [ongoing] 8
8. VIHI-Vanderbilt University Medical Center Partnership (M, N, O) - Create a list of ongoing quality improvement projects at VUMC that are suitable for student involvement - Provide students with opportunities for experiential learning of principles in quality and safety - Manuel Benegas, Jr., JD - Julie Morath, RN, MS - Melinda McCusker (SON II) - Created first list of student-friendly QI projects at VUMC [11.2009] - Set up recurring meeting (5 VUMC clinical staff members + Manny and student leaders from schools of medicine/nursing/management) to keep an ongoing list of projects and share results/progress to facilitate collective learning [2.2010] - Vanderbilt and IHI Open School Kickoff Meeting. Manny has contacted project champions from various departments and is collecting available QI projects [4.16.10] - Recruit new students to conduct projects on list [ongoing] - Establish quarterly catalogue of projects assembled by Manny [ongoing] 9
9. Certificate in Patient Safety and Quality Improvement (M, N, O) - Create an interdisciplinary (management, medicine, and nursing) program that recognizes students for didactic and experiential learning in quality improvement and patient safety - Robert Dittus, MD, MPH - Jon Lehman, MBA - Bonnie Miller, MD - Linda Norman, DSN, RN - Scott Hagan (VMS I) - Tim Lockney (VMS I) - Melinda McCusker (SON II) - Obtained Global Health Certificate Prospectus from Julie Lankford for use as model [11.2009] - Continue creation of introductory interdisciplinary elective and VMS IV quality improvement practicum, both scheduled to launch fall 2010 [ongoing] - Assemble components of certificate requirements: introductory interdisciplinary elective, list of potential projects generated from partnerships, VMS IV quality improvement practicum [ongoing] - Receive approval and support from Faculty Advisory Board [by 9. 1.10] - Create draft of prospectus [by 9.1.10] 10
10. Website (M, N, O) - Create a website for the Vanderbilt Chapter of the IHI Open School to provide information about the Chapter to the community and to document achievements of the Chapter - Sean Cunningham (Owen I) - Scott Hagan (VMS I) - Tim Lockney (VMS I) - Melinda McCusker (SON II) - Initial meeting to discuss goals/content - Recruited webmaster, Sean Cunningham - Completed Google draft of website: http://sites.google.com/site/ihivanderbilt/home [2.21.10] - Decide on final design and content of website (Google vs VU host) [by 6.1.10] - Complete design of website [by 9.1.10] 11
11. Faculty Advisory Board (M, N, O) - Establish a committee of upper-level faculty from every discipline of the Chapter to plan, evaluate, and guide the Chapter s growth - Robert Dittus, MD, MPH - Jon Lehman, MBA - Bonnie Miller, MD - Julie Morath, RN, MS - Linda Norman, DSN, RN - Theodore Speroff, PhD, PhD, MS - Scott Hagan (VMS I) - Tim Lockney (VMS I) - Melinda McCusker (SON II) - Gained initial interest of above individuals - Contact Faculty Advisory Board to organize first meeting: a strategic planning session for the organization [by 9.1.10] - Draft constitution, update mission statement, create agenda for upcoming academic year, read over the Institute for Global Health s prospectus, and begin work on our own prospectus [by 9.1.10] 12